HomeMy WebLinkAbout03-1932
BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1932
Date _ 3 -I J- - () 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. ,
Zoning:
DescriPtion of Work
~)fl~"CJ K~11 C~
~$ 7 '3 ~ 51\ lill~
Water Meter:
T.I.F,'s:
Energy Code:
~~-~
Radon Gas:
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
Permit Fee
~ignature
Company
Address
~ephone#
S'~
~c
Valuation or
Contract Price
3. ;;Lt>o
.
City license Registration #
State Certified license#
s-~ 7 -=503 {j
/
0/'\ vc'V\
Tp. Servo
Rough I
Meter an
Co t. Pole
Po I
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
MECHANICAL
BUILDING
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of twenty-five and 00/100 Dollars ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
-.-,--'----- - - - ---,-- _.._-----,-----.-.-- -- --- ~.,--:;:-,:.,~.~~.~;-:':'..~.~:~-------~ - -.-- -- - - -;-- - -~._--
...
. .". .,
GAVIN ROOFING
P,O. Box 1363
DADE CITY, FLA. 33526
Uc.#RC0046241 .. Bonded - Insured
PROI10SAL
""-,:.;
Page No.
of
Pages
(352) 567-5034
2 YEAR lEAK WARRANTY
JOH NAME I NO.
LOCATION
To:
./ -
PHONE
DATE
We hereby submit specifications and estimates for:
/
/ -'
/
'/'
~
.'"
WE PROPOSE hereby to furnish material and lab~ - complete in accordance with these specifications. for the sum o(
f/
...../
i '.
.' ,-/
>../ +-~.
dollars ($
-----.~.<.
).
Payable as follows:
,,/'
^1I malerial is guarallleed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alterations or deviation from above specifka-
tions involving extra cost will be executed only upon written orders. and will become an
exlra charge over and above the estimate. All agreements contingent upon strikes. accidents
or delays beyond our control. Owner to carry fire. tornado. and other necessary insurance.
Our workers are fully covered hy Workmen's Compensation Insurance.
Au thorized
Signature
/
.----
NOTE: This proposal may be withdrawn
by us if not accepted within __ days.
ACCEPTANCE OF PROPOSAL - The prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized
to do the work as specified. Payment will be made as outlined above.
Sig:nature
j
Date
Signature
Date
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING nBlI?ARTMBlN'r 5335 8th S'rREIll'r ZIllI?HYRHI[JI.S, P'L 33840
PhoneIB13-780-~020 FaxI813-780-0021
lJA'fBl RIllOIllIVIllD ____.." _ ~.~. ..____
PI,ANS RHlVIBlW Jl'J!lIl______"..._ ____
U\1HElR'S ITM1El_.__A!I1Lt.!.'f-y -$4{;....12//;____ ___ ____ ____ ____ _..________ PHONE CON'I'M!'!'._.___._.__ _...
7;''' *
.J08 SITE ADDRE88 _...31!7:}2__~_~__~~_________ _______ .____.._________._
LIll(]TiL DBlSCR lP'l'tulT : LOT (S)
BU)(!K
SUBDIVISION
PARC!IllI, III # .JL:.Zi. -..2I:~_e~ / 9.._~_LIfZPc? .~-:: 0 /7"~________._~.~~TA..~:I_~~RC~~__P~_r.~~~~~_=_.'I'~~ ..~~~l~T.~~~_~_.
\'lURK PROPSBlIJt [jlum C'ONS'l'RlJCTION rJ ADIJf'l'IClN []ALTElRA'rION Ll REPAIR IJ IN8TATJ!'
[JsHm
o WJVEl
[J DEMOI,ISII
PRCl!:lUSFJIJ USE: I Llsm, FTiMII,Y DWElIJLIlW
[J~1tJI,'1'I -. FAfv1Il,Y
[]# UF {'NITS
fJ SHIMMING POOL
[.] 1-10B JI,FJ I!OI1J1J
I~HER
U (X.J~1MElR(! JAI,
[J INDUSTRIAIJ
IlESCR.tP'I'ION OF NORK
C:J REI8'I'AURANT & IIElAl.TH DEPARTt-1ElN"r APPROVAI~
__ KG: __~ ;fpo~/~! C- ___________.____.___...__.______._.._
." ...___..___.+...k..___.'"'___.__.......__.._.. _ _____ _.
8UJI,TlINn SIZE
._--~_._-" --------.-.-..,
SQUARE FOOTAGE
HE! !GUT
RESIDENTIAl'I
r~m1MBlR(!IAI,1
ATTACH (2) PLOT PI"AlTS & (2) SEI'I'S OF BUu,nHll3 PLANS & (1) SEl'!' BlNElRny FOR~1S,
A'I"li1\(!!{ (3) SETS OF BUtIJIllNG PLANS & (1) SEl'!' ENEJRny FORt1S,
PROPE1RTY SURVEY RElQUIRElD FOR ALL NEW CONS'l'RtJC'I' ION ,
[] 811I LIII Nf3
/I iERMI,!S REQUESTED
$ 91..1200. ~
- -;:r-------.--.---.
VALUATION OF TOTAL CONS'I'RtJc'rIOH
L1 ElI,ElC'I'Rl eM I
----....-__.________ JU1p ~ElRVICEl
o F[.rJRIDA PO\'lElR
[J W.R.E.n,
[] PLtH18nw
o J'1BIUH1\.NWA1J
$---.-
- VAI..UATION OF MECHANCIAI, HlSTALIJA'I'TON
(] GAS
[] ROOFING
LJ SPHlctAI.'rY
[) O'I'HER
'lYPE OP' CON8'1'RtJC!'rWN I [J BU)CK
[1 FRAI.1El
[J S'l'EElIJ
[J OTHER
FIN ISHHJ1J FI,OOR ElIJEVATIONS
IS PROITElC'f' IN FLOO/) ZOI'lEl AREA n YElS
o NO
BUILlJ81R
...--'-_.__._~----,--..._-~_.~-~-_._-- ------...--------. ----.--
COr1PAN Y__._ ______..._______ ____.. __"_____. ______.____.___.
STATE CEJRT OR RElGlS'!' # __._..______._ ________._~....___._
CITY PROCESSING It__. ._......_..__..____. ___, ._.._____..._
B1GNA'I'UREl
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B1I,JllCTRICrAN
S J mlA'l'IJREJ ___._
- --'..-.---- ----+-.--.., .--.--".------ - ---._----- -.----
COI1PANY______ .___ ....____ ______ ._ '_______
STATE CERT OR REnTS'!' #
C!I'I'Y pROC'El8sn-m #
* , * * * * * , , , , * * * , , * , * * * " * , * , , , , , , , , , * , " , * , , * , , , , , , * * * , * , , , * .~ , * , , * * , *
-_.._--_.__....~...._...__..-._-. --.-- .. -. - ---".-.-.... ~--~-~---,-
PI.tJMBBlR (~OfvIPANY _ _.__.____________._______.._.__.___.__.._. _ _.._._____ _. _._
STATE: r:ERT OR REGIST # _______.___.____..._.._.___..
SWNA'l'l1REl C I'l'Y PROCESSING #
-_..-0____. .-..~--...-- -------. -.----. ~ ----.~-.---- -~__'______ _______._. .__. ... "_ __. ___~"o___. __ ____ ..__ _.._.___"'___.~ __.. .__.._
MBlC!HANICAI,
* * * , * * * , * * * , * * , * , * * 'k , , , , , * , , * , " , " " " * * * , " * * * , * , " , * " , * " * , " , .~ " , " * " " * '"
-_._~._--_._._~~---------.------------......_--_.._._-_.-
COlvlPANY_______._._____._... ..__...__._______..__ .._._..___.
STATE CElRT OR RElGI8T #
CITY PROCESSING #
-----. '"_.-.--- "'-. ~ --..--.. ._.-.'-~~_.-.._- . -.-------.
S TGNA.'I'lJREl
-- -~--_...,-----+-~---.._--~._.._-._._-- -- ------_..,--
**"*""""'''"**"*"**"**,,,**,*********,,,,,*****,*****,,'*'*'*'***"
O'rllIllR ...J:.1fz/:~ Jltt7h~~. (~0l,1PANY (:./TcJ;tJ ;f.oo,c;~/,;~
- --.----Il/-~-,--_._---------------- STATE CElRT- OR- REGIST Tf-71Zoo-uJ;i.-C?7--.------.--
8WII1\'I'URE1 --.---~-~ _._____._______.______ CITY PROCESSING # __-H:nrj;~.~~~_=~~_=.~:_=.:::=-.~-:=~~..:.-_-
**' **** * "**' '*"***"*' '* *** '**'*** '*'* * * **'" ",,*,,* '" *" ~'" '*
COHDI'l'IONS OF PERlI1I'I' AFE'IDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t this perrrdt may be subject to "deed restrictionsU which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNIJICENSED 'CON'I'RAC'I'ORS AND CON'l'RACTOR RESPONSIBII,I'I'IE:S
If the mvner- has hil'ed a contractor or. contractors to undertake work, they nlay be required
to be licensed 1n accordallce wi.th state and loca.l regulations. If the contractor ls not:
licensed as required by laH, both the ovmer and contractor may be c.ited for a Illiadellleanor
violation under state law. If the owner or 1ntended contractor are uncertain as to vlhat
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Bullding Department, 813-768-6611.
E'urthermon:, :1. f the ovlller bas hit'ed a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for Hhich they
vilLi b<:i responsible. If you, as the owner signs as the contractor, you are indicating that
YOll, lather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he 1s not properly lioensed and 1s
not entitled to permitting privileges in the City of Zephyrhills.
C. 'l'RANSI:'OR'l'ATION IMPACT fEES AND U'l'ILI'l'Y CONNECTION FEES
D. CONS'PRlIC'l'UION LIEN LAW (CliAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "Florida's Constr\lctlon
lien Law -- Homeowner's Protect1on Guide" prepared by the Florida Depat.tmellt of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", 1 cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
j t to the "owner" pr10r to corrunencement.
~1. CON'l'RAC'I'OR' S/OWNER' S AFFIDAVl'r
I certify that all the information in this applicat10n is accurate and tllat all work will
be done in compliance with all applicable .laws regulating constt-uction, zoning, and land
development.
Application 1s hereby made to obtain a permit to do work and installation as indicated. I
certify that no .wrk or installation has commenced prior to issuance of a permit and that
ail work will be performed to meet standards of all laws regUlating construction, City
codes, zoning regulations, and land development regulat.ions .in the jlll:isdictlon. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to 1dentify what actions I must take to
be in compliance. Such agencies 1nclude but are not 11mited to: *Department of
Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
Lands, Water/Wastewater Treatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"Anny Corps of Eng1neers-SeaHal.ls, Docks, Navigable WaterHays
*lJepartment of Health & Rehabilitative Services, Env1r:onmental Health lJnl.t-WeUs,
Wastewater 'l'reatmellt, Septic 'l'anks
"u.s. Environmental Protection Agency-Asbestos abatement
I a.lso certify that, if fill mater1al is to be used in Flood Zone ~A" or "A,etc.u, it is
understood that a dra1nage plan addressing a "compensating volume" 'wiLL be :mblld tt:ed Hhich
is prepared by a professional engineer registered in the. State of Flodda pdoI' 1:0 pel~lnJt
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
author1ty to violate, cancel, alter, or set aside any provis10ns of the techn1eal codes,
nor shall 1ssuance of a permit prevent the Build1ng Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every ps!mit
iermed shall become invalid unless the Hark authorized by such permit 16 oonuuenced Hithin
six months of issuance, or if work authorized by the pernd.t 1.s suspended or abandoljeld for a
period of Sill months after the t1.me the work is conunenced. One 90 day extens1.o11 of time
may be alloHed for tire permit w1th fee charge of $15.00. The extellsion shall be requeated
:1. n writing to the Buildi.ng Off1.cial. An approved inspection must be logged during eacb six
month period, or the ptoject Hill be considered abandoned.
WARlHNG TO OWNER: YOUR E'AIl,URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN E'INANqINq, .(.::qNl?UVI'
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'P. ,JOBS UNDER
$2,500 IN VAWE DO N01' NEED '1'0 RECORD AND paS'l' A "NO'nCE OF COMMENCEMEN'l'''.
----_._"~-_._-------------
SIGNA'l'URE: OWNER OR AGEI'.J'l'
-_._------~
S I GNA'!'URE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF-
The foregoing instrument was
Before me this ___ day of
by
acknowledged
.i 19~
STA'l'E OF FLORIDA
COUNTY OF
The foregoing inetrument w~s aoknowledged
Before me this .----J1ay of----, 19~_
by _____
(name of person acknowledged)
[1ho .is personally knoHn to me, or
(name of person acknowl~dged)
Dwho ls personally known to me, or
Owho has produced
(type
and who!] d1d [Jdid not
of identification)
take an oath.
o who has produced____ ____.____
(type of 1dent:ification)
and ~lbo Odid DUd not take an oath
Signature of person taking acknowledgement
Signature of pereon taking acknowledgment
._-_._--~--- -- -_.._~-~------_._-_._------~-._---
Name typed, printed or stamped
Harne typed, printed Ot stamped
111111111111111111111111I11 1111I111111111I11111111I11111111I
2003047!578
State of hOI2~OIT
NOTICE OF COMMENCEMENT
County of (fi5tfJ.
7UK ImOERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following infor~ation is provided in this Notice of Commencement:
1. Description of Property: Parcel No. @. J ( ,:7 &- ,)-/ CC?/{I J~ 7()(JO /9'0
':2 v -.? ,)'- J::!1 J /2 ""-7.J / FL-o/' / I /.l7-;o ,'-';1c:-,
'-.'f.. '," ~ "C.....,.. ,/ ' .,.{/1 ,,-_.:).),....) I'
(Legal descr~pt~on of the ert an street a ress ~ ava~ able)
2 .
General Description of Improvement
Ree: 6.00
IT: 0.00
__ Dpty Clerk
3. Ov.'Ocr Informa tion: Name
llddress ,'"?9.:...c/ ,h,,~ G-7
Interest in Property: DC1JAJ6-It..
Name of Fee Simple Titleholder:
(If other th~n owner)
State
3 3_')' 7c.;
~~~l~~~~/'IAri: rr:;o fOUNT:, C'iERK
OR BK 5278 PG 960
Address
City
-
State
Contractor: N.:lme t--/fv;:V
Address to bO'f.... lc.1U
K-ov..c;;"; (,~
Ci ty IJ/fJ}6
"-
e" 1//
./
State R- 3JS2i
5. Surety: N.:lme
,-
Address
City
State -
Amount of Bond: $
,r---
6. Lender: Name
,-
:--
Address
City
--
State ____
7.
Persons wi thi n the S ta te of Florida
notices or o:her documents may be
71.3.13(1)(a)(7), Florida Statutes:
designated by Owner upon whom
served as provided by Section
tJ"mc
,...-
Address
City
r------..
."'-----
State .~
8.
In addition to himself, Owner designates
of
Lienor's Notice as
provided
to receive a copy of the
in Section 713.13(1) (b), Florida Statutes.
<J. r-xpirnt .1'Jn dMte of nutice of Commencement (the explrati(jn date is 1 yedr
fr~m the dQte of recording unless a different date is specified.)
SignatureofOwner: @ ~~~v ~~~~
Sworn to and subscribed before tm'e this /.J-/ i:y of
~~/;?
~ L?- ~CL--
/ -- I;;) - €J <./
--::.
20 /,';
No:ary Public: @
My C.J~,;l1 S5 lon Expl.res:
~~. ..
alii!
KENNETH A. KIRCHNER
M Notary-public, State of Florida
Y Comm. expires January 12, 2004
Comm No. CC9D1618
PC93053048/ A